We provide care to a range of patients with diabetes.

We are the second inpatient diabetes service to achieve Diabetes Care Accreditation Programme (DCAP) accreditation in the UK. This shows high-quality care for people with diabetes in a range of settings, including cancer care, surgery, diabetic foot, maternity, and inpatients.

We mainly see inpatients. We help them to manage their diabetes when staying at Princess Royal University Hospital (PRUH) or Orpington Hospital.

This includes:

• managing blood sugar levels
• diabetes technologies
• managing diabetic foot
• guidance on using insulin while in hospital.

When you leave hospital, you may be reviewed in our discharge clinic, called DWARD. You will speak to a diabetes specialist nurse by phone or face-to-face, who will check your diabetes has remained safe.

We also support patients with diabetes on the maternity unit and on the PRUH Children’s wards.

If you are pregnant and have type 1 or type 2 diabetes, fill in the PRUH antenatal self-referral form.

 

You can contact us to refer a child – no GP referral needed. See Contact us.

Before your appointment

Check your appointment letter to see if you need to do anything to prepare for your appointment.

If you have two or more appointment times on the same day, they will be with different members of the team. Please attend all of the appointments.

What to bring to your first outpatient appointment

• Your appointment letter
• A list of any medicines you are taking
• Your glucose meter if you have one, and any blood sugar level results you have
• Money for prescriptions, or an exemption certificate
• A list of any questions you want to ask.

What to expect at your appointment

Please allow an hour for your clinic appointment. If you need to have blood tests or pick up a prescription, your visit may take longer than one hour.

Clinics

Diabetic foot clinic

We run many booked appointment clinics throughout the week. We can also see our patients in-between their regular appointments if their foot condition suddenly gets worse. These urgent walk-in appointments are available on Monday and Wednesday mornings until midday.

You will see a diabetes podiatrist and foot clinic nurse. You may also be reviewed by a doctor and nurse, who will advise on antibiotics and diabetes treatments.

Antenatal clinic

Our antenatal clinic supports you if you have gestational diabetes, or type 1 or type 2 diabetes during pregnancy.

You will be reviewed weekly. If you have gestational diabetes, this is usually by a diabetes nurse or dietitian. If you have type 1 or type 2 diabetes, it’s usually by a diabetes nurse or doctor.

You may also see a midwife or obstetric doctor in the same morning, so please ensure you allow time for this.

Children’s clinic (0 to 16 years) and Transition clinic (16 to 19 years)

The children’s diabetes team supports people with diabetes who are aged 19 and under. They offer regular appointments every three months, and nurse-led appointments in-between if needed.

Before you see the team, you will have your height, weight, blood pressure, and feet checked, and you will have a finger-prick blood test (HbA1c).

You will see diabetes consultant. A diabetes nurse or dietitian will usually also be at your appointment.

DWARD

For people with diabetes who have recently been discharged from hospital.

Reducing Admissions in Diabetes (RAID)

A rapid access clinic for people who urgently need to start using insulin, or where the type of diabetes is not clear. The aim is to give people the urgent support they need in an outpatient clinic, to avoid unnecessary overnight stays in hospital.

At your first appointment you will be seen by a doctor and nurse. You may see them at the same time, or one after the other.

They will ask about your diabetes history, review any blood sugar readings, and check your latest blood tests. Based on this, they will advise you of any changes to how your condition is treated or managed. You may also see a diabetes dietitian.

Glucose in Oncology/Steroid Therapy (GOST)

A rapid access clinic to support people with diabetes who need steroid therapy, or who will be having certain cancer-related interventions, such as PET scans or chemotherapy.

At your first appointment you will be seen by a doctor and nurse. You may see them at the same time, or one after the other.

They will ask about your diabetes history, review any blood sugar readings, and check your latest blood tests. Based on this, they will advise you of any changes to how your condition is treated or managed. You may also see a diabetes dietitian.

You will be monitored closely throughout your cancer treatment or steroid therapy.

Pre-Operative Diabetes Optimisation Clinic (PODOC)

For patients who need to control their diabetes further to allow them to have surgery safely.

At your first appointment you will be seen by a doctor and nurse. You may see them at the same time or one after the other.

They will ask about your diabetes history, review any blood sugar readings, and check your latest blood tests. Based on this, they will advise you of any changes to how your condition is treated or managed. You may also see a diabetes dietitian.

You will be monitored closely until you have had your operation.

Key Clinical Staff

 Name         Role

Christine Gonzalez	Endocrinology Specialist Nurse
Lynne Jerreat	Lead Diabetes Specialist Nurse
Dr Adrian Li	Consultant in Diabetes, Endocrinology and General Internal Medicine; Clinical Lead for Diabetes
Hetal Patel	Lead Diabetes Foot Practitioner

Contact us

Email: kch-tr.br-endocrinologymedsecs-pruh@nhs.net

Please give your full name, hospital number or date of birth, phone number, and your main treating clinician.

Phone: 01689 865 800

Locations

• Diabetic foot clinic, PODOC, Dietitian clinic: Farnborough Ward, Level 2, North Wing, PRUH
• DWARD, RAID, and GOST clinics: Outpatients D, Level 1, South Wing, PRUH
• Children’s Outpatients: Outpatients B, Level 1, South Wing, PRUH

For GPs and referrers

People with any type of diabetes needing optimisation in a time-critical setting should be referred to the PRUH diabetes team.

All our services can provide the latest medications where indicated and eligible, including GLP-1 agonists and technologies (continuous glucose monitoring and pumps).

Reducing Admissions in Diabetes (RAID)

Our RAID service provides a pathway to support ED and acute hospital teams with admission avoidance where urgent insulin may be needed.

Glucose in Oncology/Steroid Therapy (GOST)

Our GOST rapid-access service supports intensive optimisation prior to cancer-related interventions, such as chemotherapy (usually involving high dose steroids) or PET scans, where suboptimal diabetes can lead to cancellation.

Pre-Operative Diabetes Optimisation Clinic (PODOC)

Our PODOC service supports people with diabetes on surgery waiting lists to bring down HbA1c to nationally recommended levels, in order to reduce operation cancellations and improve peri- and post-operative outcomes.

Antenatal care

Our dedicated antenatal service supports people with diabetes through their pregnancy, working closely with midwifery and obstetric teams.

Children’s service

Our children’s service supports people with diabetes up to the age of 19yrs of age.

Diabetic foot

The PRUH diabetic foot clinic offers care for acute diabetic foot issues. It links with Same Day Emergency Care (SDEC) and hospital-at-home services to provide intravenous antibiotic therapy without hospital admission.

Referral exclusions

Patients should not be referred to the PRUH diabetes clinic services if they:

• are very frail
• have cognitive impairment
• or are housebound.

Instead, they will likely be managed by district nurses, who are linked with the community diabetes service.

Queries should be made to the PRUH service, via Epic or email: kch-tr.br-endocrinologymedsecs-pruh@nhs.net. They will be appropriately triaged, and if needed we will send letters to GPs or the community diabetes team advising of the necessary actions.

How to refer

• Use Epic for all internal referrals.
• Use e-RS for diabetic foot referrals.

Please ensure an up-to-date HbA1c blood test result (within 3 months) is included.

GPs and self-referral can be made to antenatal or children’s services.

Queries

General queries

Email: kch-tr.br-endocrinologymedsecs-pruh@nhs.net
Phone: 01689 865 800

Clinical queries

Email: kch-tr.br-endocrinologymedsecs-pruh@nhs.net – this will be redirected to the appropriate clinician.

Use Epic if internal.

Urgent queries

Call switchboard on 01689 863000 and ask for the on-call diabetes contact.